Forgot to Pay Japan NHI? Here’s What Happens
According to Japan's Health Insurance Act and National Health Insurance Act, foreigners who hold a residence card (zairyu card) and are staying in Japan for more than 3 months are legally required to be part of the national healthcare system.
Since the enrollment is mandatory, failing to pay will result in consequences.
In this article, we will explain what happens when you forget to pay your National Health Insurance in Japan and how to resolve & avoid late payments.
Japan's National Healthcare system
In Japan, it is mandatory to take part in the national healthcare.
The national healthcare system in Japan consists of the Employee Health Insurance (Shakai Hoken) and National Health Insurance (Kokumin Kenkou Hoken).
If you are a full-time employee at a Japanese company, you are already covered by the employee health insurance (Shakai Hoken) provided by the company.
However, if you are not (e.g., student, self-employed, freelancer, unemployed, etc. ), you are legally required to follow the necessary procedures to enroll in National Health Insurance (Kokumin Kenkou Hoken).
How National Health Insurance premiums are determined
The insurance premium each household pays is calculated based on several factors such as income from the previous year (January - December), age, household size, and the local government's rate.
Since calculating the exact amount can be complicated, many local governments provide quick estimation and simulators.
If you are wondering about the total amount and breakdown of your National Health Insurance premiums, it is recommended to check your local government's website.
Coverage of National Health Insurance
When you receive treatment in the case of illnesses or injuries, you have to present your National Health Insurance card for the insurance benefits.
For those under 70 years old, 70% of the medical expenses are covered by National Health Insurance, and they have to pay 30% of the total medical bill.
For those over 75 years old, 90% of the medical expenses are covered, and they have to pay 10%. However, if this person earns income equivalent to that of average working adults, he or she has to pay 30% of the total medical bill.
80% of the medical expenses are covered for those under 6 years old (before elementary school), and their parents need to pay 20% of the total medical bill.
Normally, you pay an amount according to your self-pay percentage (10%-30%) at the medical institution counter.
The High-Cost Medical Care Expense System (Kogaku Iryo-hi Seido) is a system where, if your monthly medical expenses are high, the amount that exceeds a certain self-pay limit will be reimbursed. The person who wishes to use this system must apply at the counter of their local government office.
What happens when you miss your due date
Since enrollment in National Health Insurance is mandatory for those who are not part of the Employee Health Insurance, it has similar characteristics to tax. As long as the person is registered as a resident in the city or town, whether a Japanese or a foreigner, the person is obligated to pay the National Health Insurance premiums every month.
If you fail to pay the insurance premiums by the deadline, there will be consequences.
If you continue to fail payments: Reminder & notification by phone, letters, and visits. A late fee will be added.
If you don't pay for less than a year: The NHI card will be switched to a "short-term insurance card" with a validity period of six months or so.
If you don't pay for more than a year: The card will be switched to a "qualification certificate," which, in this case, requires you to pay 100% of the medical expenses at the counter and then apply for deduction.
If you don't pay for more than 1.5 years: All or part of the health insurance benefits will be suspended, meaning that you have to pay the full amount yourself and will no longer be able to receive the benefits of National Health Insurance.
Eventually, if you continue not to pay for the National Health Insurance, your assets will be seized (including salary, life insurance, deposits, savings, real estate, etc.).
Additionally, from 40 years old, it is also required to pay for the nursing care insurance premiums. There are penalties for these if you fail to pay by the deadline.
Note: The monthly deadline is the last day of each month. If the last day of the month is a bank holiday, the following business day becomes the due date. For December, usually the due date is the first business day of the following year.
How to pay for National Health Insurance premiums
There are multiple ways to make a payment.
Bank transfer (auto pay): Apply at your local city office by submitting the bank transfer request form
Payment slip: Bring the payment slip to the bank, financial institutions, post office, local city office, and convenience store
Cashless payments: Scan the payment slip's barcode and pay with a payment app (e.g., PayPay, dPay, etc.)
Credit card: Scan the payment slip's QR code with the payment system "Mobile Register" and pay with a credit card (may or may not be possible depending on your credit card)
Deduction from pension: For some households with family members aged from 65 to 75, the insurance premiums can be paid by deduction from pensions
Insurance premium reduction for special cases
If you cannot pay the insurance premiums due to unavoidable or special circumstances, do not hesitate to contact and consult with your local government office.
There are payment reductions and special consideration for those who are in unavoidable circumstances.
Here are the cases where you are eligible for a reduction or an exemption:
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Reduction and exemptions in the event of a natural disaster or financial hardship
Households that have suffered from a natural disaster (floods, fires, earthquakes, etc.)
Households that have experienced a significant decrease in income due to retirement, business closure, illness, death, etc., and are recognized as being in financial difficulty
The details of insurance premium reduction vary depending on the local government, so consult with them as soon as possible when it is financially difficult to pay the insurance premiums.
Prevention tips for overdue payments
If you are in a financially difficult situation due to disasters or unavoidable reasons, reach out to the local city hall for a reduction or an exemption.
If you tend to forget to pay the monthly insurance premiums because you are busy, you can apply for a bank transfer monthly auto payment at your local city hall.
However, if you do not have a Japanese bank account, using reminder tools and bill-payment services will help you avoid missing the deadline.
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Frequently asked questions
Here are some of the frequently asked questions about National Health Insurance premiums in Japan.
Q: What happens if I forget to pay for National Health Insurance in Japan?
If you have a residence card (zairyu card), are staying for more than 3 months in Japan, and are not working for a company full-time, you are legally required to enroll in the National Health Insurance. If you fail to pay by the deadline, there will be reminder notices by phone, letters, and visits. Also, the late fee will be added. Eventually, your National Health Insurance will be suspended, and your assets will be seized.
Q: Can I pay for National Health Insurance at a convenience store?
Yes. You can bring your NHI payment slip to the convenience store cash register and pay. However, you cannot pay at a convenience store if the payment due date has passed. Also, if the payment slip doesn't have the convenience store barcode or the payment amount exceeds ¥300,000, you cannot pay at the convenience store.
In closing
It is legally required for every resident, regardless of their nationality, to be part of the national health care program in Japan.
If you work for a Japanese company full-time, you are automatically covered by the Employee Health Insurance. However, if not, you must enroll in National Health Insurance.
There will be serious consequences, and eventually seizure of assets, if you fail to pay by the deadline and are in arrears.
To avoid potential problems, it is important to inquire with your local government office, choose the best payment method that suits you, and seek additional help.
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